Melnick: Clark County measles outbreak will be costly, prolongedFree

The measles outbreak in Clark County that has racked up 23 confirmed cases since Jan. 1 isn’t likely to go away or slow down any time soon, even though no new cases or exposure locations were confirmed Wednesday.

There are seven suspected measles cases, according to a Clark County Public Health news release. One new suspected case has been reported in King County.

At Wednesday morning’s Clark County Board of Health meeting, Clark County Public Health Officer Dr. Alan Melnick warned the Clark County Council that the measles outbreak could last months, spread into other Washington counties, south to Oregon and possibly cost Clark County hundreds of thousands of dollars.

Melnick said the first several days of the outbreak response effort cost somewhere around $31,000.

“This is going to be likely hundreds of thousands of dollars if not more,” Melnick told the council. “This is going to be pretty expensive.”

A statewide emergency?

The outbreak might be declared a statewide emergency, after being declared a Clark County public health emergency by the council last week. A statewide declaration would most likely happen if the outbreak continues to increase in numbers, and reaches other counties, Melnick said.

“It’s very possible that we’ll be seeing cases outside of Clark County, including other spots in Washington as well as to our neighbors to the south,” Melnick said.

Officials are investigating a suspected measles case in King County.

Public Health Seattle & King County said Wednesday that a man in his 50s was hospitalized but has been released. Officials say the man had recently traveled to Vancouver, but it’s not clear if that’s where he might have been infected. Officials say results from additional testing to confirm the case are expected by the end of the week.

How measles spreads

It takes seven to 21 days from when someone is exposed to measles to when they develop symptoms and become contagious, Melnick said. He said the outbreak is entering its third or fourth generation, meaning the outbreak starts with a single case that then infects secondary cases, which then can infect another group as the disease starts multiplying and creating new generations.

“We’re getting into the third and fourth generation, and as you can imagine, the numbers can increase,” he told the council. “I’m hoping some of the measures we’ve taken can reduce that. But there’s a good possibility well be dealing with measles in continuing numbers and perhaps even increasing numbers in the next few weeks and months.”

A statewide emergency means that federal resources can be tapped. Melnick said Clark County Public Health is being stretched thin by the outbreak. Public Health is having to pull staff from other departments to help assist in the response.

Some food inspectors have shifted over in the response effort, which means they’re not only leaving their main duties, but also leaving a role (food inspection) that collects fees for the county.

“This basically impacts everything that we do,” Melnick said. “But we are faced with this potentially deadly outbreak here, and it’s a matter of prioritizing our resources and it’s kind of all hands on deck right now.”

Fighting misinformation

Melnick says Public Health is not only fighting an outbreak, but also a campaign against false information that appears frequently online.

“Unfortunately, there’s a lot of misinformation going around on social networks, and some of it is very sophisticated looking and very well done,” Melnick said.

“In the 25 years that I’ve known about immunizations and the controversy over it, there are things on the web and there are organizations that say that vaccinations cause autism and that’s why some parents are reluctant to have their children vaccinated,” Council Chair Eileen Quiring said. She said that sometimes when people say something over and over and over again, others can perceive it as truth, even if it isn’t.

“The link between vaccination and autism has been debunked a long time ago,” Melnick said. “There’s also misinformation going on about shedding the vaccine virus and causing other people to get infected. That’s also been debunked, but it’s very believable. I think that’s difficult for parents, because they look at this stuff and it seems very legitimate. But it’s not true. That’s what we’re up against.”

Low immunization rates

Clark County has a lower immunization rate than other parts of the state and nation. Melnick says the low rates mostly stem from people requesting personal and philosophical exemptions. He said religious exemptions are rare, as are health-related exemptions.

The trend toward exemptions has slowed in recent years after new legislation required parents to meet with a medical provider to discuss vaccines and exemptions. Regardless, Melnick said Clark County’s vaccination rates are too low.

At the 11 schools for which immunization data was available, 678 of 6,958 students were listed as being exempt from receiving their measles, mumps and rubella vaccines during the 2017-2018 school year.

According to the Washington State Department of Health, Battle Ground Public School’s River HomeLink has the highest rate of students who do not have MMR shots. Of the 1,019 students enrolled at the school, 239, or 23.5 percent, are not immunized against the highly contagious virus.

Data was not available for Slavic Christian Academy, a private school located in Orchards.

Clark County Public Health is requiring exclusion of students and staff without documented immunity to measles from only schools identified as possible exposure sites. Students and staff excluded from those identified schools are also excluded from other schools, child care and other congregate settings.

Students and staff at schools where measles exposure did not occur are not impacted by exclusions.

Melnick said it would be tragic for a child to die because of the outbreak; if everyone was vaccinated, he said, measles could be eliminated. He also said that about 400 to 500 people died per year from measles before the vaccine.

Councilor Julie Olson, who represents District 2, said she wished that people would take the disease more seriously.

“This a preventable disease,” Olson said. “The idea that it is not dangerous is just wrong. That we allow our children to be exposed to this kind of illness and put them through this kind of suffering is unconscionable.”

What to do if you might be infected

The Centers for Disease Control and Prevention reports that 90 percent of unvaccinated people exposed to the measles virus come down with the disease. The virus lives in the nose and throat mucus of an infected person, and can survive for up to two hours in an airspace where the infected person coughed or sneezed.

Health officials are urging anyone who has been exposed at an identified location and believes they have symptoms of measles to call their health care provider prior to visiting the medical office to make a plan that avoids exposing others in the waiting room.

If you are unsure of your family’s immunization status, you can view, download and print your family’s immunization information online at MyIR.net or request a copy of your immunization record from the Washington State Department of Health.

Anyone with questions about measles infection or the measles vaccine should call their primary care provider or a county health department:

• Clark County Public Health, 360-397-8021

• Multnomah County Public Health, 503-988-3406

• Washington County Public Health, 503-846-3594

• Clackamas County Public Health, 503-655-8411

Public Health has identified additional locations where people may have been exposed to measles. There are dozens of locations in total, including hospitals, Portland International Airport and multiple schools. For a complete list of exposure sites, visit the Public Health measles investigation webpage.

Measles symptoms begin with a high fever, cough, runny nose and red eyes, followed by a rash that usually begins at the head and spreads to the rest of the body. A person can spread the virus before they show symptoms. People are contagious with measles for up to four days before and up to four days after the rash appears. After someone is exposed to measles, illness develops in about one to three weeks.

The Associated Press contributed to this report.